Male Breast Cancer

In the depth of winter, I finally learned that within me there lay an invincible summer.

— Albert Camus

What is the risk of breast cancer in men?
Breast cancer does occur in men, although it is relatively rare. In 2005, an estimated 1,690 cases will be diagnosed and 460 men will die from the disease (American Cancer Society). In the United States, male breast cancer accounts for less than one percent of male cancers. Like breast cancer in women, the incidence of breast cancer in men increases with age.

What are some of the risk factors for male breast cancer?
According to the National Cancer Institute and other data, risk factors for breast cancer in men include:

• Previous radiation treatment to the chest
• Testicular dysfunction and other conditions causing hormone imbalances
• Having a disease related to higher levels of estrogen in the body (cirrhosis of the liver) or Klinefelter’s syndrome (a genetic disorder that causes a decreased production of male hormones)
• Having family members (male or female) who have had breast cancer, especially a family history that indicates a possible BRCA2 (or possibly BRCA1) gene mutation
• Increased age (the average age of diagnosis is 65)

What are the signs or symptoms of male breast cancer?
Many of the signs or symptoms of male breast cancer are the same as for women. These may include:

• A lump or swelling in the breast, nipple or chest muscle
• Dimpling or puckering of the skin in the breast/chest area
• Retraction of the nipple (turning inward)
• Discharge from the nipple
• Redness, scaling or irritation of the breast skin or nipple.

A more common breast disorder that occurs in men is gynecomastia, which is an increase in the amount of a man’s breast tissue. It is not a malignant tumor. In any case, if a man notices any of these symptoms, it is important that he sees his healthcare provider immediately for evaluation.

Because men have very little breast tissue, a cancer does not need to grow very far before it may involve the skin covering the breast or the muscles underneath the breast. This means that while the tumor may be small, it is possible that the cancer has spread beyond the breast. Delayed detection of breast cancer can reduce survival.

How is breast cancer in men diagnosed and treated?
For the most part, diagnosis and treatment of breast cancer in men is much the same as in women. The procedures used for diagnosis could include: complete medical history, clinical breast exam, diagnostic mammography, breast ultrasound and/or biopsy. (For more detailed information, see Making the Diagnosis.)

Treatment depends on the type and stage of the breast cancer. Surgical and radiation options for men may differ from those available for women. Because the male breast contains very little tissue, treatment usually involves removal of the tumor through modified radical mastectomy, including removal of the nipple and areola. In addition, if the tumor has infiltrated the chest wall, it may be necessary to remove all or a portion of the pectoralis muscles.

Following surgery and evaluation of the tumor, treatment such as chemotherapy, radiation or hormone therapy (such as tamoxifen) may be recommended. Side effects from these treatments are similar to those experienced by women under treatment for breast cancer. (For more detailed information, see After the Diagnosis and Managing Side Effects of Treatment.)

What are some of the challenges that men with breast cancer face?
One of the first challenges is lack of awareness. Many people are not aware that men can develop breast cancer. Because male breast cancer is so rare, men are less likely to seek medical attention if they have symptoms. This often results in diagnosis of breast cancer at later stages.

The longer symptoms are ignored, the greater the chances of the disease advancing. Diagnosis of breast cancer at later or more advanced stages generally warrants more aggressive treatment and may reduce survival rates.
Because of the perception by many that men do not get breast cancer, a man may have difficulty receiving and accepting the diagnosis. He may experience a wide range of conflicting emotions, including fear, embarrassment, or feeling isolated. He may also have concerns relating to his masculinity, particularly because breast cancer is predominantly considered “a woman’s disease.”

What Can Men Do?

• Realize that breast cancer CAN occur in men, especially as they get older.
• If you notice a lump in your breast or any of the breast symptoms mentioned above, make sure you see a doctor to have it evaluated.
• If you have a significant family history of breast cancer (males or females) or any other of the risk factors listed above, ask your doctor if he or she recommends screening for breast cancer on a regular basis.
• If you are diagnosed with breast cancer, you are not alone. There are resources available and other men to talk to who have been diagnosed with breast cancer.

RESOURCES

Organizations

American Cancer Society (ACS)
800.ACS.2345 or 866.228.4327 (TTY)
www.cancer.org
Provides information and services for all forms of cancer, diagnosis, treatment and other topics. Free fact sheets, support and resources about male breast cancer.

John W. Nick Foundation
772.589.1440
www.johnwnickfoundation.org
This nonprofit organization focuses on increasing awareness of male breast cancer, includes personal stories of male breast cancer survivors, and has an information booklet.

Susan G. Komen Breast Cancer Foundation
972.855.1600 or 800.I’M.AWARE (800.462.9273)
www.komen.org
Foundation for breast cancer research, education, screening and treatment. Has a toll-free helpline (800.I’M.AWARE) for callers with breast health/cancer concerns. Offers the free fact sheet, “Facts for Life: Breast Cancer in Men.”

National Cancer Institute’s Cancer Information Service
800.4.CANCER (800.422.6237)
www.cancer.gov
One of the best resources available for cancer patients, this government organization provides the toll-free
hotline above in English and Spanish for questions about any type of cancer. Has information about male breast cancer and treatment.

Y-ME National Breast Cancer Organization
800.221.2141 or 800.986.9505 (Spanish)
www.y-me.org
Provides breast cancer education and support. Call the 24-hour, toll-free breast cancer information hotline above
to be matched with a male breast cancer survivor for information and support.

Books and More

The Cancer Guide for Men, by Helen Beare & Neil Priddy (1999). The focus of this book is on coping with cancer from a male perspective. It is intended to help men who have been diagnosed with cancer and are trying to come to terms with it.

The Official Patient’s Sourcebook on Male Breast Cancer: A Revised and Updated Directory for the Internet Age, by James N. Parker, MD and Philip M. Parker, PhD, Editors (2002). Helps patients know where and how to look for information covering virtually all topics related to male breast cancer, from the essentials to the most advanced areas of research.

Web Sites

Imaginis.com
www.imaginis.com/breasthealth/bcmen.asp
Has information on symptoms and types of male breast abnormalities, risk factors, diagnosis, treatment and
survival rates for male breast cancer, and resources.

Male Breast Cancer, by Carol E.H. Scott-Conner, MD, PhD, University of Iowa Hospitals and Clinics
www.surgery.uiowa.edu/surgery/oncology/malebreastcancer.html
Has general information about signs and symptoms
of male breast cancer, diagnosis and treatment.

Male Breast Cancer Discussion List
www.acor.org
Click on Mailing Lists to the left, enter MALEBC in the search box at the top to sign up. This public online support group provides information and community to its members.

Male Breast Cancer, From The Breast Cancer Fund
www.breastcancerfund.org/disease_male_bc.htm
Information and resources about male breast cancer